Fertility and Aging Men An Introduction to the Male Biological Clock

Puneet Masson, Sarah M. Lambert, Peter N. Schlegel, and Harry Fisch

Data obtained in the past decade suggested a worldwide decline in male fertility. The increase in paternal age is both a personal problem for couples and a public health problem because of the simple fact that male fertility declines with age. Journal articles by Kidd and Ford demonstrate that men over the age of 35 are twice as likely to be infertile as men younger than 25. In addition, a study of couples undergoing fertility treatments found that the amount of time it takes for a man to achieve a pregnancy rises significantly with age.

The levels of sex hormones in men decline with age. The roughly 1% per year decline in testosterone levels after age 30 has been termed andropause, or ''symptomatic hypogonadism in the aging male.'' Rhoden and Morgentaler estimate that between 2 and 4 million men in the United States alone suffer from hypogonadism, but only 5% of men are getting treatment for their symptoms.

Although increasing maternal age has long been known to be associated with an increased incidence of birth defects, new data show that the age of the male does matter and the genetic quality of sperm does decline with age. Several studies have demonstrated that older men are at higher risk of fathering a child with various genetic diseases such as schizophrenia and Down Syndrome, to name a few. Additionally, there has been an increased risk of miscarriage with increasing paternal age.

This review discusses the relationship between advanced paternal age and male infertility. Continuing this dialogue will improve the sexual and reproductive health of aging males.

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